【摘要】 目的 分析1990-2021年中国年轻(15～39岁)女性乳腺癌疾病负担的变化趋势及其主要危险因素，为该人群针对性防控提供循证依据。方法 基于全球疾病负担研究(GBD)2021数据库，提取中国年轻女性乳腺癌的发病率和死亡率数据。采用Joinpoint回归分析时间趋势，计算年度变化百分比(APC)和平均年度变化百分比(AAPC)。运用年龄-时期-队列模型评估年龄、时期及出生队列效应，并分析归因危险因素。结果 1990-2021年中国年轻女性乳腺癌的标准化发病率从6.50/10万上升到12.08/10万，标准化死亡率从2.34/10万下降到1.64/10万，2015年后有所上升。Joinpoint分析结果表明，中国年轻乳腺癌的发病率以每年2.0%的速度增长(AAPC=2.0%,P<0.001),而死亡率以每年1.0%的速度逐年下降的(AAPC=-1.0%,P<0.001)。发病率在2002-2015年增速最快(APC=2.4%),2015年后进一步上升(APC=3.5%)。死亡率在2004-2007年下降最显著(APC=-4.2%),但2015年后略有回升(APC=0.9%)。年龄效应中年轻乳腺癌的发病、死亡风险随着年龄增长而增加；以2002-2006年为参考时期，发病风险的时期效应总体呈上升趋势，而死亡风险总体呈下降趋势，2015年后有所回升；以1975-1979年为对照组，发病风险的队列效应总体上有所升高，死亡风险呈下降趋势。高红肉饮食(归因死亡率0.13/10万)、二手烟暴露(0.02/10万)和高血糖(0.02/10万)是导致死亡的主要危险因素。结论 中国年轻女性乳腺癌的发病率持续上升，近期死亡率和疾病负担有回升趋势，需加强早期筛查和针对危险因素的干预。更多还原

【Abstract】 Objective To assess temporal trends in the disease burden of breast cancer and its major risk factors among young women(15-39 years) in China from 1990 to 2021, providing evidence-based support for targeted interventions. Methods Based on the Global Burden of Disease Study(GBD) database in 2021, incidence and mortality data of breast cancer among young women in China were extracted. The annual percentage change(APC) and average annual percentage change(AAPC) were calculated by Joinpoint to analyze temporal trends. An age-period-cohort model was employed to evaluate the effects of age, period, and birth cohort, and to analyze the attributable risk factors. Results From 1990 to 2021, the standardized incidence rate of young women with breast cancer in China increased from 6.50 per 100 000 to 12.08 per 100 000, and the standardized mortality rate decreased from 2.34 per 100 000 to 1.64 per 100 000, with a slight increase after 2015. Joinpoint analysis showed that the incidence rate of young breast cancer in China was increasing at an annual rate of 2.0%(AAPC=2.0%,P<0.001),while the mortality rate were decreasing at an annual rate of 1.0%(AAPC=-1.0%,P<0.001).Incidence rate increased fastest from 2002to 2015(APC=2.4%),and further increased after2015(APC=3.5%).The mortality rate decreased most significantly from 2004to 2007(APC=-4.2%),but slightly rebounded after 2015(APC=0.9%).In the age effect,the risk of incidence and mortality of young breast cancer increased with age.Taking the period from 2002to 2006as a reference,the period effect of incidence risk showed an overall upward trend,while the risk of death showed an overall downward trend,with a slight rebound after 2015.Compared to the control group from 1975to1979,the cohort effect of incidence risk generally increased,while the risk of death showed a decreasing trend.A high red meat diet(attributable mortality rate of 0.13per 100 000),secondhand smoke exposure(0.02per 100 000),and hyperglycemia(0.02per 100 000)were the main risk factors for death.Conclusions The incidence rate of breast cancer among young women in China continues to rise,and the mortality rate and disease burden are on the rise in the near future.It is necessary to strengthen early screening and targeted risk factor intervention.更多还原